Individual provider Active NPI

Elizabeth Dawn Crane, LCSW

  • Clinical Social Worker
  • Hannibal, MO
National Provider Identifier
1891353538
Registry record updated Aug 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
2022039940 Issued in MO
Practice address
2 Melgrove LN Ste 204
Hannibal, MO 63401-2200
Phone
(573) 600-0730
NPI assigned
May 29, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2019006982 MO
Clinical Social Worker 1041C0700X 2022039940 MO Primary

Addresses

Primary practice location

2 Melgrove LN Ste 204
Hannibal, MO 63401-2200

Mailing address

2 Melgrove LN Ste 204
Hannibal, MO 63401-2200
Phone (573) 600-0730

Other names 1

  • Elizabeth Dawn Crane Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221025001239 MO Practitioner - Clinical Social Worker 8921474487 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2019006982MOMDClinical Social Worker
2022039940MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mark Twain Association for Mental Health, Inc. CurrentSince Oct 10, 2022 Accepting new patients
Mark Twain Association for Mental Health, Inc CurrentSince Oct 10, 2022 Accepting new patients

Locations

2 Melgrove Ln
Ste 204
Hannibal, MO 63401
Phone (573) 221-0102

154 Forrest Dr
Hannibal, MO 63401
Phone (573) 221-2120

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690848000000",
    "number": "1891353538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 MELGROVE LN STE 204",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012200",
            "telephone_number": "573-600-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 MELGROVE LN STE 204",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634012200",
            "telephone_number": "573-600-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANE",
        "first_name": "ELIZABETH",
        "middle_name": "DAWN",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2023-08-01",
        "certification_date": "2023-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2019006982",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MO",
            "license": "2022039940",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELIZABETH",
            "last_name": "CRANE",
            "middle_name": "DAWN",
            "credential": "LCSW",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.